allergic rhinitis

Question 1

most common type of rhinitis

Answer 1

allergic rhinitis

Question 2

sx of allergic rhinitis (5)

Answer 2

congestion
malaise
clear drainage
SNEEZING
red itchy eyes

Question 3

how long do sx of allergic rhinitis

Answer 3

weeks at a time

Question 4

viral vs allergic rhinitis

Answer 4

viral– erythematous (beefy red) turbinates
allergic– edematous, pale or violet boggy turbinates; nasal polyps w/ cobblestone mucosa

Question 5

inflammation of nasal cavity mucosa?

Answer 5

rhinitis

Question 6

inflammation of both nose and sinuses?

Answer 6

rhinosinusitis

Question 7

infection caused by sinus ostia obstruction

Answer 7

sinusitis

Question 8

catarrhal inflammation of the mucous membrane in the nose, caused especially by a cold or by hay fever

Answer 8

coryza

Question 9

what causes allergic rhinitis

Answer 9

Type 1 hypersensitivity rxn– IgE mediated mast cell histamine release d/t allergens

Question 10

3 medications related to non-allergic rhinits

Answer 10

CPAP
beta blocker (-lol)
ace inhibitor (-pril)

Question 11

2 endocrine issues related to non-allergic rhinitis

Answer 11

hypothyroidism, pregnancy

Question 12

3 types of rhinitis

Answer 12

seasonal allergic (grass, tree)
perenial allergic (dust mite, mold, dander)
non-allergic (irritant, medication)

Question 13

3 key PE signs suspicious for bacterial sinusitis

Answer 13

persistent sx 10+ days (fails to improve by day 10)
severe sx 3+ days
double worsening sx 3+ days

Question 14

what is double worsening

Answer 14

when sx worsen w/in 10 days after initially getting better

Question 15

when should you get CT scan?

Answer 15

for sinusitis complications
confirm chronic sinusitis

Question 16

PE of bacterial vs viral (what you see inside the nose)

Answer 16

bacterial– erythema or edema; PURULENT drainage WITHIN the nose or posterior pharynx
viral– erythematous, engorged nasal mucosa w/o intranasal purulence

Question 17

non-allergic inflammation of nasal tissues causing paroxysmal sneezing, nasal congestion, excessive runny nose or post nasal drip

Answer 17

vasomotor rhinitis

Question 18

signs of vasomotor rhinitis

Answer 18

nasal mucosa over turbinates is congested and hypertrophic

Question 19

tx of vasomotor rhinitis (4)

Answer 19

avoid triggers
antihistamines & oral decongestants
topical & systemic steroids
surgery

Question 20

rebound phenomenon after excessive use of decongestant nasal drops after 3 consecutive days of use

Answer 20

rhinitis medicamentosa (RM)

Question 21

what causes nasal polyps

Answer 21

mostly allergic rhinitis
also cystic fibrosis

Question 22

nasal polyps on PE

Answer 22

on direct visualization, you see pale boggy mass on nasal mucosa

Question 23

tx of nasal polyps (2)

Answer 23

1 intranasal corticosteroids

may need surgery

Question 24

inflammation for 12+ consecutive weeks

Answer 24

chronic sinusitis

Question 25

most likely cause of chronic sinusitis

Answer 25

fungal– aspergillus or mucormycosis

Question 26

how is chronic sinusitis diagnosed?

Answer 26

biopsy or histology

Question 27

when should you recommend topical steroids for allergic rhinitis? what if its not adequate?

Answer 27

if sx affect quality of life
if inadequate, can add intranasal antihistamine

Question 28

3 things to tx symptoms of allergic rhinitis

Answer 28

topical nasal steroid (mometasone)
oral antihistamine
saline irrigation